Laryngeal Trauma: Saving the Voice after Injury

Laryngeal Trauma: Saving the Voice after Injury

Treating laryngeal trauma is often delicate and challenging, given the larynx’s crucial role in speaking, breathing, and swallowing.

Dr Ramya Bharathi, an ENT (Ear, Nose, and Throat) surgeon and Otolaryngologist at Tufts Medical Center, Boston, MA, has encountered various cases of laryngeal trauma, each requiring a tailored approach to restore the patient’s voice.

“The larynx, comprising vocal cords, cartilages, muscles, and nerves, is complex and vulnerable to injuries from accidents, sports, or violence. The consequences of such trauma can be far-reaching,” explains Dr. Bharathi. 

She adds severe cases, like those from car accidents, can leave a patient struggling with speech and breathing: “Such a case highlights the acute nature of these types of injuries and the swift response required.”

Diagnosis of laryngeal trauma involves careful examination, often employing endoscopy to assess the damage. Treatment depends on injury severity, ranging from conservative management to surgical intervention. 

“Surgical repair focuses on restoring function and preserving the voice and breathing, balancing reconstructive surgery and therapy,” Dr Bharathi states. 

Emphasizing the technical skill required and the profound impact on patients’ lives, she says: “Surgical repair of the larynx is a highly intricate and delicate process. 

“My approach always focuses on two critical aspects: restoring function and preserving the voice. This often involves a balance of reconstructive surgery and therapy. Each surgery is a high-stakes procedure, not just because of the technical skills required but also due to the profound impact on the patient’s quality of life.”

Postoperative care is vital reveals Dr Bharathi: “Recovery from laryngeal trauma doesn’t end with surgery. Speech therapy, is often crucial. I often work closely with speech-language pathologists to help patients regain their voice. Seeing someone speak again, fearing they might lose their voice forever, is incredibly rewarding.”

Advancements in medical technology have significantly improved laryngeal trauma outcomes. Innovations in surgical techniques and diagnostic tools have been game-changers in treatment success. 

However, Dr Bharathi notes that treating laryngeal trauma involves not only physical challenges but emotional ones, adding: “Losing the ability to speak, even temporarily, can be terrifying. Providing emotional support and counseling to patients and families is crucial to my role.”

Dr. Bharathi has made substantial contributions to her department since 2019. Her academic journey at Saint Louis University School of Medicine and the College of New Rochelle laid a strong foundation for her successful career. 

With numerous accolades and peer-reviewed publications, Dr Bharathi is an active participant in academic forums and a member of key medical societies, reflecting her deep commitment to otolaryngology.

Dr Maria Koenigs is an Assistant Professor of Surgery and Pediatrics at the Warren Alpert School of Medicine at Brown University, Division of Otolaryngology.

She has had experience working in laryngeal trauma with Dr Bharathi: “We had a patient with a rare condition known as a laryngeal fracture, essentially a fractured voice box. Such cases, according to standard medical textbooks, typically necessitate immediate surgical intervention, often involving a breathing tube or a tracheostomy tube. However, one night at 1 am,  Dr Bharathi, as a diligent and astute trainee, evaluated the patient and her assessment revealed he was faring significantly better than the textbook scenarios.”

Dr Koenigs added Dr Bharathi boldly decided to advocate for a less aggressive treatment approach, believing it was in the patient’s best interest: “In her pursuit of the best course of action, Ramya reached out to me for a discussion. She detailed her observations and reasoning, showcasing her diligence and hard work and her ability to think critically and beyond conventional wisdom.”

This kind of exceptional skill sets trainees apart, says Dr Koenigs: “Ramya had a commitment to continuous care. She ensured she was present for the patient’s subsequent visit to the operating room two weeks later, keen to follow up on her initial intervention. This level of involvement in the entire treatment process, especially in decision-making and patient care, is extraordinary.”

In her work, Dr Bharathi is a surgeon and guardian of one of the most precious human abilities – the power of voice. Her cases in laryngeal trauma are among the most challenging yet rewarding, constantly reminding her of the resilience of the human body and spirit.

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